ANNIE DERTHICK (NPI# 1689039422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689039422 |
| Entity Type | Individual |
| Full Name | ANNIE DERTHICK |
| Credential | PHD |
| Practice Address |
76 High St Lewiston ME 04240 |
| Mailing Address |
76 High St Lewiston ME 04240-7649 |
| Practice Telephone | 2077952800 |
| Mailing Telephone | 2077952800 |
| Enumeration Date | 2015-12-21 |
| Last Update Date | 2018-09-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 107779 | AK | Behavioral Health & Social Service Providers |
| Y | 103TF0000X |
Psychologist Specialization: Family |
PS1563 | ME | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1201 E 36th Ave, Anchorage, AK 995084372 | 9075629229 | 9075614806 |
| Street Address |
76 HIGH ST |
| City | LEWISTON |
| State | ME |
| Zip Code | 04240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386637627 | Dale Leroy Sotherland | Internal Medicine | 76 High St, Suite 300, Lewiston, ME 04240-7649 | 2005-08-23 |
| 1528677838 | Benjamin Landry | Pharmacist | 76 High St, Lewiston, ME 04240-7649 | 2020-07-23 |
| 1497372940 | Colin Bonnar | Family Medicine | 76 High St, Lewiston, ME 04240-7649 | 2020-07-01 |
| 1982220224 | Emily Nguyen | Family Medicine | 76 High St, Lewiston, ME 04240-7649 | 2020-06-23 |
| 1114543725 | Anna Korkhin | Family Medicine | 76 High St, Lewiston, ME 04240-7649 | 2020-06-19 |
| 1184249906 | James Poulin | Family Medicine | 76 High St, Lewiston, ME 04240-7649 | 2020-06-09 |
| 1013539022 | Eliza Foster | Family Medicine | 76 High St, Lewiston, ME 04240-7649 | 2020-05-13 |
| 1386266393 | Matthew Rausch | Family Medicine | 76 High St, Lewiston, ME 04240-7649 | 2020-05-13 |
| 1831711845 | Catherine Lok | Family Medicine | 76 High St, Lewiston, ME 04240-7649 | 2020-05-13 |
| 1316593171 | Sarah Sue Gurney | Nurse Practitioner | 76 High St, Lewiston, ME 04240-7649 | 2019-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773882 | Hannah Page Guerrette | Speech-Language Pathologist | 2 Strawberry Ave, Lewiston, ME 04240 | 2020-09-03 |
| 1497392500 | Samuel C Larouche | Social Worker | 100 Campus Ave Stes A&b, Lewiston, ME 04240 | 2019-12-09 |
| 1972145019 | Pomarand Behavioral Services | Nurse Practitioner | 217 Main St., Suite 201, Lewiston, ME 04240 | 2019-10-10 |
| 1396248258 | William Bucklin | Counselor | 17 Main St Fl 2, Lewiston, ME 04240 | 2018-03-16 |
| 1548769524 | Kevin Ryan | Physician Assistant | 12 High Street Suite 102, Lewiston, ME 04240 | 2018-02-06 |
| 1033637673 | Wellness Center | Clinic/Center | 37 Park Street, Suite 305, Lewiston, ME 04240 | 2017-09-04 |
| 1710404561 | Colasante Chiropractic, LLC | Clinic/Center | 184 Webster Street, #100, Lewiston, ME 04240 | 2017-08-23 |
| 1609398544 | Lindsey Laforge | Occupational Therapist | 984 1/2 Sabattus Street, Lewiston, ME 04240 | 2017-07-12 |
| 1861922478 | Seth Toothaker | Counselor | 1190 Lisbon Street, Lewiston, ME 04240 | 2017-06-15 |
| 1861850828 | Black Bear Support Services, LLC | Community/Behavioral Health | 571 Sabattus Street, Suite 15, Lewiston, ME 04240 | 2016-02-05 |
| Find all providers in zip 04240 | ||||
| Taxonomy Code | 103TF0000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013194620 | Betty Massie | Psychologist | 322 Main St, Bar Harbor, ME 04609-1648 | 2008-01-25 |
Please comment or provide details below to improve the information on ANNIE DERTHICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.